Individual
DR. GINO J PIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
(208) 232-2408
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
(208) 232-2408
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5829
ID
183500000X
Pharmacist
RPH-0010704
OR
Other
Enumeration date
02/19/2010
Last updated
03/30/2020
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